Turkiye Klinikleri Journal of Ophthalmology

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Oküler Yüzey Hastalıklarında Otolog Plateletten Zengin Plazma Tedavisinin Etkinliği
The Effectiveness of Autologous Platelet Rich Plasma Treatment in Ocular Surface Diseases
Özlem DİKMETAŞa, Özge DELİKTAŞa, Sibel KOCABEYOĞLUa, Murat İRKEÇa
aHacettepe Üniversitesi Tıp Fakültesi, Göz Hastalıkları ABD, Ankara, TÜRKİYE
Turkiye Klinikleri J Ophthalmol. 2021;30(2):86-91
doi: 10.5336/ophthal.2020-77780
Article Language: TR
Full Text
ÖZET
 Amaç: Plateletten zengin plazma (PZP) otolog, koruyucu madde içermeyen ve büyüme faktörlerinden zengin olması nedeniyle hücre farklılaşması, çoğalması ve göçünü mümkün kılan bir tedavi yöntemidir. Bu çalışmanın amacı, oküler yüzey hastalıklarında otolog topikal PZP tedavisinin güvenilirliğini ve etkinliğini araştırmaktır. Gereç ve Yöntemler: Oküler yüzeyi etkileyen hastalıklara (ağır kuru göz sendromu, rekürren korneal epitel defekti, radyasyon ve nörotrofik epitelyopati) yönelik PZP tedavisi verilen toplam 21 hastanın, 21 gözü retrospektif olarak değerlendirildi. Otoimmün hastalığı olanlar çalışma dışı bırakıldı. Hastalara, 10 gün boyunca günde 4 defa otolog PZP tedavisi topikal olarak uygulandı . Tedaviden önce ve sonra hastaları n görme keskinlikleri (logMAR), Schirmer testi, Oxford sınıflamasına göre floresein ile korneal boyanma değerleri, subjektif yakınmaları fotofobi, lakrimasyon, ağrı ve rahatsızlık hissi sorgulandı. Tedavi öncesi ve sonrası bu değerler karşılaştırıldı. İstatistiksel karşılaştırmalarda eşleştirilmiş t-testi kullanıldı. Bulgular: Çalışmaya dâhil edilen 21 hastanın 15'i erkek 6'sı kadın olup, yaş ortalaması 47,4±13,4 (18-73 yaş) olarak saptandı. Oküler yüzey boyanma (tedavi öncesi 3,4±0,7, sonrası 1,3±0,5, p˂0,001), Schirmer testi (tedavi öncesi 5,1±1,5 mm/5 dk, sonrası 5,8±1,6 mm/5 dk, p=0,013), görme keskinliği (tedavi öncesi 0,6±0,5 logMAR, sonrası 0,5±0,6 logMAR, p=0,926) değerleri tedavi öncesine göre normal değerlere yaklaştı ve oküler yüzey boyanma değerleri istatistiksel olarak anlamlı düzelme gösterdi (p<0,001). Hastaların subjektif yakınmalarında ise rahatsızlık ve fotofobinin 19 (%90,5) hastada kaybolduğu, lakrimasyon ve ağrının ise %100 oranında kaybolduğu görüldü. Hiçbir hastada genel veya lokal yan etki gelişmedi. Sonuç: Oküler yüzeyi etkileyen ve diğer medikal tedavilere dirençli olgularda PZP tedavisi, hem objektif hem de subjektif bulgularda belirgin düzelme sağlayan etkili bir tedavi yöntemidir.

Anahtar Kelimeler: Otolog plateletten zengin plazma; oküler yüzey hastalıkları; kuru göz; büyüme faktörleri
ABSTRACT
 Objective: Platelet-rich plasma (PRP) is an autologous, unpreserved treatment method which enables cell differentiation, proliferation and migration due to its growth factors. The aim was to evaluate the reliability and the effect of topical autologous platelet rich plasma in patients with ocular surface diseases. Material and Methods: 21 eyes of 21 patients who were given PRP with the diagnosis of diseases (severe dry eye syndrome, recurrent corneal epithelial defect, radiation epitheliopathy, neurotrophic epitheliopathy) were evaluated retrospectively. The patients with autoimmune disease were excluded from the study. Patients received autologous PRP topical therapy 4 times a day for 10 days. Visual acuity (logMAR), Schirmer test, fluorescein and corneal staining values with Oxford classification system and subjective complaints photophobia, lacrimation, pain and discomfort were questioned and evaluated. These values were compared before and after treatment. Paired t-test was used for the comparisons. Results: The patients who were included in the study were twenty-one patients (15M/6F) [mean age=47.4±13.4 years (range=18- 73 years)]. Ocular surface staining (before treatment: 3.4±0.7, after treatment: 1.3±0.5, p˂0.001), Schirmer test (before treatment: 5.1±1.5 mm/5 dk, after: 5.8±1.6 mm/5 dk, p=0.013), visual acuity (before treatment: 0.6±0.6, after: 0.5±0.6 logMAR, p=0.926) values approached normal compared to pretreatment and ocular surface staining values showed a statistically significant improvement (p <0.001). In the subjective complaints of the patients, discomfort and photophobia disappeared by 19 (90.5%), and lacrimation, pain disappeared by 100%. No patients had general or local side effects. Conclusion: PRP treatment is an effective treatment that provides significant improvement in both objective and subjective findings in ocular surface diseases which have not been treated with other treatments.

Keywords: Autologous platelet-rich plasma; ocular surface diseases; dry eye; growth factors
REFERENCES:
  1. Alio JL, Rodriguez AE, WróbelDudzińska D. Eye platelet-rich plasma in the treatment of ocular surface disorders. Curr Opin Ophthalmol. 2015;26(4):325-32. [Crossref] [PubMed] 
  2. Anitua E, Muruzabal F, de la Fuente M, Merayo J, Durán J, Orive G. Plasma rich in growth factors for the treatment of ocular surface diseases. Curr Eye Res. 2016;41(7):875-82. [Crossref] [PubMed] 
  3. Franchini M, Cruciani M, Mengoli C, Marano G, Capuzzo E, Pati I, et al. Serum eye drops for the treatment of ocular surface diseases: a systematic review and meta-analysis. Blood Transfus. 2019;17(3):200-9. [PubMed] [PMC] 
  4. Eğrilmez S. Kan ürünü gözyaşı takviyeleri. [Blood-derived tear substitutes]. MN Oftalmoloji. 2016;23(1):40-7. [Link] 
  5. Le Q, Xu J, Deng SX. The diagnosis of limbal stem cell deficiency. Ocul Surf. 2018;16(1):58-69. [Crossref] [PubMed] [PMC] 
  6. Suzuki T, Teramukai S, Kinoshita S. Meibomian glands and ocular surface inflammation. Ocul Surf. 2015;13(2):133-49. [Crossref] [PubMed] 
  7. Willcox MDP, Argüeso P, Georgiev GA, Holopainen JM, Laurie GW, Millar TJ, et al. TFOS DEWS II Tear Film Report. Ocul Surf. 2017;15(3):366-403. [Crossref] [PubMed] [PMC] 
  8. Nugent RB, Lee GA. Ophthalmic use of blood-derived products. Surv Ophthalmol. 2015;60(5):406-34. [Crossref] [PubMed] 
  9. Nurden AT. Platelets, inflammation and tissue regeneration. Thromb Haemost. 2011;105 Suppl 1:S13-33. [Crossref] [PubMed] 
  10. Soni NG, Jeng BH. Blood-derived topical therapy for ocular surface diseases. Br J Ophthalmol. 2016;100(1):22-7. [Crossref] [PubMed] 
  11. Acer S, Yalnız Akkaya Z, Tök ÖY, Burcu A, Örnek F. Kornea ve konjonktiva hastalıklarında amniyotik membran transplantasyonu. [Amniotic membrane transplantation in corneal and conjunctival diseases]. Turkiye Klinikleri J Med Sci. 2012;32(3):609-17. [Crossref] 
  12. Ribeiro MVMR, de Melo VF, Barbosa MEFC, de FrançaTozzi MU, Ramos MSB, Gaia NMSRS, et al. The use of platelet rich-plasma in ophthalmology: a literature review. Revista Brasileira de Oftalmologia. 2017;76(6):319-24. [Crossref] 
  13. Pflugfelder SC. Tear dysfunction and the cornea: LXVIII Edward Jackson Memorial Lecture. Am J Ophthalmol. 2011;152(6):900-9.e1. [Crossref] [PubMed] [PMC] 
  14. Geerling G, Hartwig D. Autologe Serum-augentropfen zur therapie der augenoberfläche eine ubersicht zur wirksamkeit und empfehlungen zur anwendung. [Autologous serum-eye-drops for ocular surface disorders. A literature review and recommendations for their application]. Ophthalmologe. 2002;99(12):949-59. [Crossref] [PubMed] 
  15. Ralph RA, Doane MG, Dohlman CH. Clinical experience with a mobile ocular perfusion pump. Arch Ophthalmol. 1975;93(10):1039-43. [Crossref] [PubMed] 
  16. Tsubota K. Tear dynamics and dry eye. Prog Retin Eye Res. 1998;17(4):565-96. [Crossref] [PubMed] 
  17. Fox RI, Chan R, Michelson JB, Belmont JB, Michelson PE. Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sicca. Arthritis Rheum. 1984;27(4):459-61. [Crossref] [PubMed] 
  18. de Paiva CS, Pflugfelder SC, Ng SM, Akpek EK. Topical cyclosporine a therapy for dry eye syndrome. Cochrane Database Syst Rev. 2019;13;9(9):CD010051. [Crossref] [PubMed] [PMC] 
  19. Wróbel-Dudzińska D, Alio J, Rodriguez A, Suchodoła-Ratajewicz E, Kosior-Jarecka E, Rymgayłło-Jankowska B, et al. Clinical efficacy of platelet-rich plasma in the treatment of neurotrophic corneal ulcer. J Ophthalmol. 2018;2018:3538764. [Crossref] [PubMed] [PMC] 
  20. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea. 2003;22(7):640-50. [Crossref] [PubMed] 
  21. Begley C, Caffery B, Chalmers R, Situ P, Simpson T, Nelson JD. Review and analysis of grading scales for ocular surface staining. Ocul Surf. 2019;17(2):208-20. [Crossref] [PubMed] 
  22. Alio JL, Rodriguez AE, Abdelghany AA, Oliveira RF. Autologous platelet-rich plasma eye drops for the treatment of post-LASIK chronic ocular surface syndrome. J Ophthalmol. 2017;2017:2457620. [Crossref] [PubMed] [PMC] 
  23. Alio JL, Rodriguez AE, De Arriba P, Gisbert S, Abdelghany AA. Treatment with platelet-rich plasma of surgically related dormant corneal ulcers. Eur J Ophthalmol. 2018;28(5):515-20. [Crossref] [PubMed] 
  24. Riestra AC, Alonso-Herreros JM, Merayo-Lloves J. Platelet rich plasma in ocular surface. Arch Soc Esp Oftalmol. 2016;91(10): 475-90. [Crossref] [PubMed] 
  25. Anitua E, Muruzabal F, Tayebba A, Riestra A, Perez VL, Merayo-Lloves J, et al. Autologous serum and plasma rich in growth factors in ophthalmology: preclinical and clinical studies. Acta Ophthalmol. 2015;93(8):e605-14. [Crossref] [PubMed] 
  26. Arnalich F, Rodriguez AE, Luque-Rio A, Alio JL. Solid platelet rich plasma in corneal surgery. Ophthalmol Ther. 2016;5(1):31-45. [Crossref] [PubMed] [PMC] 
  27. Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf. 2017;15(3):539-74. [Crossref] [PubMed] 
  28. Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-83. [Crossref] [PubMed] 
  29. Alio JL, Colecha JR, Pastor S, Rodriguez A, Artola A. Symptomatic dry eye treatment with autologous platelet-rich plasma. Ophthalmic Res. 2007;39(3):124-9. [Crossref] [PubMed] 
  30. García-Conca V, Abad-Collado M, Hueso-Abancens JR, Mengual-Verdú E, Pi-ero DP, Aguirre-Balsalobre F, et al. Efficacy and safety of treatment of hyposecretory dry eye with platelet-rich plasma. Acta Ophthalmol. 2019;97(2):e170-e8. [Crossref] [PubMed] 
  31. Avila MY, Igua AM, Mora AM. Randomised, prospective clinical trial of platelet-rich plasma injection in the management of severe dry eye. Br J Ophthalmol. 2018;3:bjophthalmol-2018-312072. [PubMed] 
  32. Pezzotta S, Del Fante C, Scudeller L, Cervio M, Antoniazzi ER, Perotti C. Autologous platelet lysate for treatment of refractory ocular GVHD. Bone Marrow Transplant. 2012;47(12):1558-63. [Crossref] [PubMed] 
  33. Alio JL, Abad M, Artola A, Rodriguez-Prats JL, Pastor S, Ruiz-Colecha J. Use of autologous platelet-rich plasma in the treatment of dormant corneal ulcers. Ophthalmology. 2007;114(7):1286-93.e1. [Crossref] [PubMed] 
  34. Avila MY. Restoration of human lacrimal function following platelet-rich plasma injection. Cornea. 2014;33(1):18-21. [Crossref] [PubMed] 
  35. Ali TK, Gibbons A, Cartes C, Zarei-Ghanavati S, Gomaa M, Gonzalez I, et al. Use of autologous serum tears for the treatment of ocular surface disease from patients with systemic autoimmune diseases. Am J Ophthalmol. 2018;189:65-70. [Crossref] [PubMed] 
  36. Alio JL, Arnalich-Montiel F, Rodriguez AE. The role of "eye platelet rich plasma" (E-PRP) for wound healing in ophthalmology. Curr Pharm Biotechnol. 2012;13(7):1257-65. [Crossref] [PubMed] 

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